Order Form

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        |  QTY. | Description/Size/Color     | Price |   Sub-Total   |

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                                      sub-total           ___________

 

                    VA Residents add 4.5% Sales Tax   ___________

 
 $2.00 upcharge for XXX & XXXX sizes
 U.S. Shipping: $3.50 per shirt (shipped via US Post Office Priority Mail)

 

          GRAND TOTAL         $__________

 

        Your Name ___________________________________________________

 

        Address______________________________________________________

 

        Address______________________________________________________

 

        City____________________________ State____Zip________________

 

        Telephone (    )     -       InterNet________________________

 

Please send this form, along with payment in full (in U.S. funds drawn on 

a U.S. bank), to: Raven Restaurant 1200 Alantic Ave VA Beach VA 23451.  

Payment via Money Order is preferred (required on all foreign orders), checks 

*must* clear before sending item(s). Cash is sent at your own risk.  Payment 

via secured funds will usually result in order going out immediately.